New Patient Forms
New Patient FormsFilling out this paperwork prior to coming in for your visit will allow you more time to talk to the doctor about your specific concerns. We look forward to seeing you. Click on the bolded PDFs below to print and fill out relevant forms. If you have difficulty printing the forms, they can be provided to you by our staff upon request. You will need to allow for extra time to fill out the information the day of your appointment.
All New Patients:
To expedite your appointment all new patients are encouraged to please print all 4 forms below (there may be other forms below that could be applicable for your specific care). Please bring them completed to your upcoming appointment.
DETAILED FORMS FOR SPECIFIC PATIENTS (review and select as necessary):
Nasal/sinus patients:
If you are a new patient seeing our sinus doctors for concerns related to nasal/sinus/allergy symptoms please print and fill out the following before your first appointment:
Allergy patients:
If you are a new patient seeing our allergy physicians for concerns related to allergy symptoms please print and fill out the following before your first appointment:
Allergy forms and FAQs
Once your allergy doctor assesses whether you will require allergy testing, the following forms will be necessary to review and fill out before your first appointment:
Ear patients:
If you are a new patient seeing our ear doctors for concerns related to ear conditions or symptoms, please print and fill out the following before your first appointment:
Snoring/sleep apnea patients:
If you are a new patient seeing our sleep apnea doctors for concerns related to snoring and obstructive sleep apnea, please print and fill out the following before your first appointment:
Hoarseness patients:
If you are a new patient seeing our voice doctors for concerns related to hoarseness please print and fill out the following before your first appointment:
Pediatric patients:
If you are a parent/family member of a new pediatric patient please print and fill out the following before your first appointment:
Transfer patients:
If you are interested in releasing your medical information from another physician's office to Proliance South Seattle Otolaryngology these forms can assist you in your efforts:
All New Patients:
To expedite your appointment all new patients are encouraged to please print all 4 forms below (there may be other forms below that could be applicable for your specific care). Please bring them completed to your upcoming appointment.
- New Patient Registration Form PDF
- HIPAA form PDF
- New Patient Health History PDF
- Patient Financial Responsibility PDF
DETAILED FORMS FOR SPECIFIC PATIENTS (review and select as necessary):
Nasal/sinus patients:
If you are a new patient seeing our sinus doctors for concerns related to nasal/sinus/allergy symptoms please print and fill out the following before your first appointment:
Allergy patients:
If you are a new patient seeing our allergy physicians for concerns related to allergy symptoms please print and fill out the following before your first appointment:
Allergy forms and FAQs
Once your allergy doctor assesses whether you will require allergy testing, the following forms will be necessary to review and fill out before your first appointment:
Ear patients:
If you are a new patient seeing our ear doctors for concerns related to ear conditions or symptoms, please print and fill out the following before your first appointment:
- Ear questionnaire
Snoring/sleep apnea patients:
If you are a new patient seeing our sleep apnea doctors for concerns related to snoring and obstructive sleep apnea, please print and fill out the following before your first appointment:
Hoarseness patients:
If you are a new patient seeing our voice doctors for concerns related to hoarseness please print and fill out the following before your first appointment:
Pediatric patients:
If you are a parent/family member of a new pediatric patient please print and fill out the following before your first appointment:
- New Pediatric Health Questionnaire PDF
- Consent for care of minor by non-parent PDF (not needed if parent or guardian is present)
Transfer patients:
If you are interested in releasing your medical information from another physician's office to Proliance South Seattle Otolaryngology these forms can assist you in your efforts:
